Facial and Dental Arch Growth Following Palatal Surgery

描述：唇腭裂的发生率约为1/750，是最常见的先天性畸形之一。腭裂手术修复的主要目标是在不损害面部或牙弓生长的情况下，构建一个能够支持正常非鼻语言的腭咽口。未修复的唇腭裂的成年人很少有凹陷的中脸，这通常是在婴儿期修复的唇腭裂的成年人的特征。与手术相关的因素可能是中脸生长障碍的主要原因。佛罗里达大学（University of Florida）与巴西圣保罗大学（University of Sao Paulo, bauuru）合作，提出了一项纵向研究，以确定6至10岁出生时患有完全性单侧唇腭裂的儿童，其面部和/或牙弓关系是否因修复唇腭裂的手术技术而不同，以及/或因接受腭外科手术时的年龄而不同。本研究拟纳入目前正在进行的NIDCR赞助的一项研究的475名患者，该研究正在评估相对于受试者所接受的手术技术的言语和腭咽结局措施。受试者被随机分配进行唇部手术（Spina vs Millard技术）、腭部手术（von Langenbeck vs. Furlow手术）和腭部修复年龄（9-12个月vs. 15-18个月）。本研究将提供数据，确定这一非常大的患者群体中上颌生长和牙弓的关系，由此得出结论，关于Millard或Spina唇修复与von Langenbeck腭成形术或双反z形腭修复对面部和牙弓生长的相对重要性。该研究的第二部分将是舌咽部语言功能的长期随访。

DESCRIPTION: The incidence of cleft lip/palate is approximately 1/750, making it one of the most common congenital malformations. The primary goal in surgically repairing the palatal cleft is to construct a velopharyngeal port capable of supporting normal non-nasal speech without impairing growth of the face or Dental arches. Adults with unrepaired cleft lip and palate rarely have the recessed midface that too often characterizes the profile of adults whose cleft lip and palate have been repaired in infancy. Factors associated with the surgery are likely the major cause of midface growth disturbance. The University of Florida, in collaboration with the University of Sao Paulo, Bauru, Brazil, is proposing a longitudinal study to determine whether children between 6 and 10 years of age, born with complete unilateral cleft lip and palate, have different facial and/or Dental arch relationships as a function of the surgical techniques used in repairing their lip and/or palate, and/or as a function of their age when they received palatal surgery. This study proposes to enroll the entire patient pool of 475 patients who currently are subjects in an ongoing NIDCR sponsored study in which speech and velopharyngeal outcome measures are being assessed relative to the surgical techniques subjects underwent. Subjects were randomly assigned for lip surgery (Spina vs. Millard technique), palatal surgery (von Langenbeck vs. Furlow procedure), and age of palatal repair (9-12 months vs. 15-18 months). The proposed study will provide data defining the maxillary growth and Dental arch relationships in this very large group of patients, from which conclusions should be possible regarding the relative importance of the Millard or Spina lip repair and the von Langenbeck palatoplasty or the double opposing z-plasty palate repair on facial and Dental arch growth. A secondary part of the study will be a long-term follow-up of velopharyngeal function for speech.